“Screening”is a search for preclinical,asymptomatic disease,including cancer.Widespread cancer screening has led to large increases in early-stage cancers and pre-cancers.Ubiquitous public messages emphasize the pot...“Screening”is a search for preclinical,asymptomatic disease,including cancer.Widespread cancer screening has led to large increases in early-stage cancers and pre-cancers.Ubiquitous public messages emphasize the potential benefits to screening for these lesions based on the underlying assumption that treating cancer at early stages before spread to other organs should make it easier to treat and cure,using more tolerable interventions.The intuition is so strong that public campaigns are sometimes launched without conducting definitive trials directly comparing screening to usual care.An effective cancer screening test should not only increase the incidence of early-stage preclinical disease but should also decrease the incidence of advanced and metastatic cancer,as well as a subsequent decrease in cancer-related mortality.Otherwise,screening efforts may be uncovering a reservoir of non-progressive and very slowly progressive lesions that were not destined to cause symptoms or suffering during the person’s remaining natural lifespan:a phenomenon known as“overdiagnosis.”We provide here a qualitative review of cancer overdiagnosis and discuss specific examples due to extensive population-based screening,including neuroblastoma,prostate cancer,thyroid cancer,lung cancer,melanoma,and breast cancer.The harms of unnecessary diagnosis and cancer therapy call for a balanced presentation to people considering undergoing screening,even with a test of accepted benefit,with a goal of informed decision-making.We also discuss proposed strategies to mitigate the adverse sequelae of overdiagnosis.展开更多
Background This is the inaugural issue of the Journal of the National Cancer Cen-ter(JNCC),a journal designed to appeal to the international commu-nity of health professionals and researchers across the full spectrum ...Background This is the inaugural issue of the Journal of the National Cancer Cen-ter(JNCC),a journal designed to appeal to the international commu-nity of health professionals and researchers across the full spectrum of cancer research.One of its goals is to contribute to cancer research dis-semination and cancer care around the world.We offer this Perspective to emphasize the importance of international collaborations in cancer investigation and in the timely dissemination of research findings.We also describe examples of our own ongoing cross-country collaboration as members of a team of Chinese and U.S.investigators.展开更多
文摘“Screening”is a search for preclinical,asymptomatic disease,including cancer.Widespread cancer screening has led to large increases in early-stage cancers and pre-cancers.Ubiquitous public messages emphasize the potential benefits to screening for these lesions based on the underlying assumption that treating cancer at early stages before spread to other organs should make it easier to treat and cure,using more tolerable interventions.The intuition is so strong that public campaigns are sometimes launched without conducting definitive trials directly comparing screening to usual care.An effective cancer screening test should not only increase the incidence of early-stage preclinical disease but should also decrease the incidence of advanced and metastatic cancer,as well as a subsequent decrease in cancer-related mortality.Otherwise,screening efforts may be uncovering a reservoir of non-progressive and very slowly progressive lesions that were not destined to cause symptoms or suffering during the person’s remaining natural lifespan:a phenomenon known as“overdiagnosis.”We provide here a qualitative review of cancer overdiagnosis and discuss specific examples due to extensive population-based screening,including neuroblastoma,prostate cancer,thyroid cancer,lung cancer,melanoma,and breast cancer.The harms of unnecessary diagnosis and cancer therapy call for a balanced presentation to people considering undergoing screening,even with a test of accepted benefit,with a goal of informed decision-making.We also discuss proposed strategies to mitigate the adverse sequelae of overdiagnosis.
文摘Background This is the inaugural issue of the Journal of the National Cancer Cen-ter(JNCC),a journal designed to appeal to the international commu-nity of health professionals and researchers across the full spectrum of cancer research.One of its goals is to contribute to cancer research dis-semination and cancer care around the world.We offer this Perspective to emphasize the importance of international collaborations in cancer investigation and in the timely dissemination of research findings.We also describe examples of our own ongoing cross-country collaboration as members of a team of Chinese and U.S.investigators.
